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J Clin Res Pediatr Endocrinol. 2012 Mar;4(1):8-13. doi: 10.4274/jcrpe.521.

Association between apolipoprotein E polymorphism and subclinic atherosclerosis in patients with type 1 diabetes mellitus.

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Selçuk University, Meram Faculty of Medicine, Department of Pediatric Endocrinology, Konya, Turkey.



The most important cause of morbidity and mortality in type 1 diabetes mellitus (DM) is atherosclerosis. Apolipoprotein E (Apo E) polymorphism is accused of being the genetic risk factor for atherosclerosis. The aim of the present study was to determine which Apo E polymorphism was related to atherosclerosis in patients with type 1 DM.


Seventy-four patients with type 1 DM were enrolled in the study. Age, diabetes duration, daily insulin dose, microalbuminuria, and major cardiovascular risk factors including anthropometric and metabolic parameters were assessed in each patient. Non-invasive ultrasonographic measurements were also performed. For determination of Apo E genotype, DNA was extracted from venous blood from all subjects using standard methods. Apo E genotyping was performed using a PCR-restriction fragment-length polymorphism assay.


Systolic blood pressure and carotid artery intima-media thickness (CA-IMT) were increased in subjects with E4/E4 polymorphism. According to univariate analysis, when adjusted for all risk factors, genotypes did not differ for total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol and triglycerides (p>0.05). However, E3/E3, E3/E4 and E4/E4 genotypes were found to be associated with an increase in CA-IMT (p<0.001).


Our results suggest that the polymorphism associated with atherosclerosis in type1 DM is Apo E4/E4.

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